Comparing contraceptive choices and continuation among post-abortion patients with and without free access to long-acting reversible contraception

Vinita Goyal, MD, MPH, Population Research Center, University of Texas at Austin

Project abstract

The proposed research project takes advantage of a Medicaid 1115 waiver program implemented at Planned Parenthood in Austin, Texas, offering free LARC and counseling emphasizing LARC methods to post-abortion patients aged 24 and under. Women aged 25 and over will receive the same counseling, but will not be offered LARC for free. We will recruit a cohort of 500 women, half of whom qualify for the program and half of whom do not, and follow them over a 12-month period.

In this natural experiment whereby women are assigned to receive free LARC on the basis of an arbitrary age cut-off we will be able to isolate the effect of cost alone on LARC uptake, timing of insertion, continuation, and repeat pregnancy in a largely unbiased population seeking abortion services, not free contraception. We will also assess women's desired method of contraception and explore the reasons why certain methods are desired or not desired, both when cost is and is not a barrier.

Since this study will be conducted in Texas, which has experienced drastic reductions to publicly funded family planning programs, we will be able to gauge the extent to which repeat unintended pregnancies and repeat abortions could be avoided if Planned Parenthood of Greater Texas had the ability to offer free LARC to its entire abortion patient population.